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However, the long-term effect of maternal multiple micronutrient levels in the second trimester on the overall development of preschoolers remains unknown. Therefore, 1017 singleton mother\u2013infant pairs and 6-year-old preschoolers were recruited based on the China-Wuxi Birth Cohort Study. Meanwhile, information on the demographic characteristics of pregnant women and preschoolers, maternal copper, calcium, iron, magnesium, and zinc levels in whole blood during the second trimester, and neonatal outcomes, were collected. We aimed to investigate the long-term impact of maternal copper, calcium, iron, magnesium, and zinc levels in the second trimester on mild thinness among 6-year-old preschoolers, and the modifying effect of small for gestational age (SGA), within the Chinese population. Multiple logistic regression models revealed that high-level maternal iron in the second trimester reduced the risk of mild thinness [adjusted OR: 0.46 (95% CI: 0.26, 0.80)] among 6-year-old preschoolers. However, no significant association was found for the remaining four maternal essential metal elements. Additionally, the restricted cubic spline function showed that the risk of mild thinness decreased when maternal iron concentration exceeded 7.47 mmol\/L in whole blood during the second trimester. Furthermore, subgroup analysis indicated that the long-term protective effect of high-level maternal iron on mild thinness was only observed in SGA infants. Summarily, high-level maternal iron in the second trimester distinctly lowers the risk of mild thinness among 6-year-old preschoolers, especially in preschoolers with birth outcomes of SGA. Our findings offer evidence for the implementation of iron supplementation in the second trimester as a preventive measure against mild thinness in children.<\/jats:p>","DOI":"10.3390\/nu15183939","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T03:54:06Z","timestamp":1694490846000},"page":"3939","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Long-Term Effect of Maternal Iron Levels in the Second Trimester on Mild Thinness among Preschoolers: The Modifying Effect of Small for Gestational Age"],"prefix":"10.3390","volume":"15","author":[{"given":"Kai-Wen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng-Jia","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"},{"name":"Department of Medical Genetics and Prenatal Diagnosis, Wuxi Maternity and Child Health Care Hospital, Wuxi 214002, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song-Jia","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Wei","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Jing","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua-Long","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Department of Medical Genetics and Prenatal Diagnosis, Wuxi Maternity and Child Health Care Hospital, Wuxi 214002, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1164\/rccm.201604-0693OC","article-title":"Evaluation of the Global Lung Initiative 2012 Reference Values for Spirometry in African Children","volume":"195","author":"Arigliani","year":"2017","journal-title":"Am. 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